Which adverse effect is reported with ranitidine, famotidine, and cimetidine?

• A. Drug-induced hepatitis
• B. Hyperglycemia
• C. Tinnitus
• D. Allergic rash

Answer: (A)

H2 receptor antagonists can cause rare liver injury. Drug-induced hepatitis has been reported with these drugs, including ranitidine, famotidine, and cimetidine, and it is an idiosyncratic reaction that can occur in some patients regardless of dose. If liver injury occurs, signs such as jaundice, dark urine, fatigue, or right upper quadrant pain, along with abnormal liver tests, prompt discontinuation of the drug and evaluation. The other options aren’t characteristic shared adverse effects of this drug class: hyperglycemia and tinnitus aren’t typical, and allergic rash can occur but is not the hallmark adverse effect associated with all three.